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Recognising acute atopic eczema flare-ups

author/source: DrB & DrN



Dr Peter Norén says: "The sooner an acute eczema flare-up is recognised, the better it can be treated!"

After the few weeks needed for The Combined Approach to successfully treat chronic, or longstanding, atopic eczema - that has caused months and years of distress - the follow-up plan focuses on the early recognition of subsequent episodes of acute eczema, also called flare-up or acute inflammation

Early effective treatment of flare-ups will mean less and less trouble as convalescence procedes.

If triggers are known and can be avoided, a flare-up may not happen: otherwise, having available optimal topical treatment will mean as soon as a flare-up is identified, it can be successfully treated in a few days only - and without habit reversal.


There are four features of acute inflammation to watch out for:

1) Dryness - an increase in dryness is both a trigger factor and an early feature of inflammation.

2) Itchiness - itchiness may signal a need for increased frequency of emollient, but it is also an early indicator of inflammation.

3) Redness - or erythema, which is the main feature of acute inflammation. In the case of pale skin the shade of redness is relatively bright and distinct, but it is important to note that in the case of skin of colour acute inflammation can have a less distinct, darker purple shade of red. In all cases of erythema firm touch pressure on the surface of the affected skin will diminish the colour change - see below.*

4) Roughness - as the inflammation progresses the affected skin swells and feels rough to touch.


  • The roughness of acute eczema is different to that of chronic eczema, where the skin becomes thickened by lichenification, a process of skin overactivity stimulated by regular scratching.
  • *In skin of colour lichenification is associated with hyperpigmentation - firm touch pressure on the surface of the affected skin will not diminish this colour change.



As soon as a flare-up is noticed, treat it!

It only takes a few days!